Hostname: page-component-78c5997874-j824f Total loading time: 0 Render date: 2024-11-19T22:13:13.677Z Has data issue: false hasContentIssue false
  • English
  • Français

Advancing the screening of fibromyalgia in late-life depression: practical implications for psychiatric settings

Published online by Cambridge University Press:  24 April 2015

John R. Jochum ,
Amy E. Begley ,
Mary Amanda Dew ,
Debra K. Weiner  and
Jordan F. Karp
John R. Jochum
Affiliation:
University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
Amy E. Begley
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
Mary Amanda Dew
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Departments of Epidemiology, Biostatistics, and Psychology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Clinical and Translational Science Institute, Pittsburgh, PA, USA
Debra K. Weiner
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Clinical and Translational Science Institute, Pittsburgh, PA, USA Department of Anesthesiology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Department of Medicine, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Geriatric Research Education and Clinical Center, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
Jordan F. Karp*
Affiliation:
Department of Psychiatry, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA Clinical and Translational Science Institute, Pittsburgh, PA, USA Department of Anesthesiology, University of Pittsburgh School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
*
Correspondence should be addressed to: Jordan F. Karp, MD, Western Psychiatric Institute and Clinic, 3811 O’Hara Street, Pittsburgh, PA 15213, USA. Phone: 412-246-6048; Fax: 412-246-6030. Email: [email protected].
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Fibromyalgia (FM) is common in older adults suffering from mood disorders. However, clinical diagnosis of FM is challenging, particularly in psychiatric settings. We examined the prevalence of FM and the sensitivity of three simple screeners for FM.

Methods:

Using cross-sectional data, we evaluated three tests against the American College of Rheumatology (ACR) 1990 Criteria for the Classification of FM: a “Do you often feel like you hurt all over?” question, a pain map score, and the Pope and Hudson (PH) interview for FM. Participants were 185 community-dwelling adults ≥ 60 years old with comorbid depression and chronic low back pain evaluated at a late-life mental health clinic.

Results:

Fifty three of 185 participants (29%) met the ACR 1990 FM criteria. Compared to those without FM, the FM group had more “yes” answers to the “hurt all over?” question and higher pain map scores. To reach a sensitivity of at least 0.90, the cut-off score for the pain map was 8. The sensitivity of the pain map, “hurt all over?” question, and PH criteria were 0.92 [95%CI 0.82–0.98], 0.91 [95%CI 0.79–0.97], and 0.94 [95%CI 0.843–0.99] respectively.

Conclusions:

Nearly one in three older adults suffering from depression and chronic low back pain met ACR 1990 FM criteria. Three short screening tests showed high sensitivity when compared to the ACR 1990 FM criteria. Implementation of one of the simple screeners for FM in geriatric psychiatry settings may guide the need for further diagnostic evaluation.

Keywords

fibromyalgiascreeningagingpaindepression
Type
Research Article
Information
International Psychogeriatrics , Volume 27 , Issue 9 , September 2015 , pp. 1513 - 1521
Copyright
Copyright © International Psychogeriatric Association 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Arnold, L. M. (2008). Management of fibromyalgia and comorbid psychiatric disorders. Journal of Clinical Psychiatry, 69 (Suppl. 2), 14–19.Google ScholarPubMed
Arnold, L. M., Clauw, D. J. and McCarberg, B. H. (2011). Improving the recognition and diagnosis of fibromyalgia. Mayo Clinic Proceedings, 86, 457–464.Google Scholar
Arnold, L. M., Hudson, J. I., Keck, P. E., Auchenbach, M. B., Javaras, K. N. and Hess, E. V. (2006). Comorbidity of fibromyalgia and psychiatric disorders. Journal of Clinical Psychiatry, 67, 1219–1225.Google Scholar
Berger, A., Dukes, E., Martin, S., Edelsberg, J. and Oster, G. (2007). Characteristics and healthcare costs of patients with fibromyalgia syndrome. International Journal Clinical Practice, 61, 1498–1508.Google Scholar
Clauw, D. J. (2007). Fibromyalgia: update on mechanisms and management. Journal of Clinical Rheumatology, 13, 102–109.Google Scholar
Eggermont, L. H., Shmerling, R. H. and Leveille, S. G. (2010). Tender point count, pain, and mobility in the older population: the mobilize Boston study. Journal of Pain, 11, 62–70.CrossRefGoogle ScholarPubMed
Fiest, K. M., Currie, S. R., Williams, J. V. and Wang, J. (2011). Chronic conditions and major depression in community-dwelling older adults. Journal of Affective Disorders, 131, 172–178.Google Scholar
Goldenberg, D. L. (2009). Diagnosis and differential diagnosis of fibromyalgia. American Journal of Medicine, 122, S14–S21.Google Scholar
Harth, M. and Nielson, W. R. (2007). The fibromyalgia tender points: use them or lose them? A brief review of the controversy. Journal of Rheumatology, 34, 914–922.Google Scholar
Herr, K. A. and Garand, L. (2001). Assessment and measurement of pain in older adults. Clinics in Geriatric Medicine, 17, 457–478.Google Scholar
Herr, K., Spratt, K. F., Garand, L. and Li, L. (2007). Evaluation of the Iowa pain thermometer and other selected pain intensity scales in younger and older adult cohorts using controlled clinical pain: a preliminary study. Pain Medicine, 8, 585–600.CrossRefGoogle ScholarPubMed
Karp, J. F. and Reynolds, I. I. I. C. F. (2009). Depression, Pain, and Aging. FOCUS: The Journal of Lifelong Learning in Psychiatry, 7, 17–27.CrossRefGoogle Scholar
Karp, J. F. et al. (2012). Addressing both depression and pain in late life: the methodology of the ADAPT study. Pain Medicine, 13, 405–418.Google Scholar
Katz, R. S., Wolfe, F. and Michaud, K. (2006). Fibromyalgia diagnosis: a comparison of clinical, survey, and American college of Rheumatology criteria. Arthritis Rheumatology, 54, 169–176.Google Scholar
Kroenke, K., Spitzer, R. L. and Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16, 606–613.CrossRefGoogle ScholarPubMed
Kruger, T. M., Abner, E. L., Mendiondo, M., Schmitt, F. A., Smith, C. D. and Jicha, G. A. (2012). Differential reports of pain and depression differentiate mild cognitive impairment from cognitively intact elderly participants. Journal of Geriatric Psychiatry Neurology, 25, 107–112.CrossRefGoogle ScholarPubMed
Kunz, M., Mylius, V., Schepelmann, K. and Lautenbacher, S. (2009). Effects of age and mild cognitive impairment on the pain response system. Gerontology, 55, 674–682.Google Scholar
Lingjaerde, O., Ahifors, U., Bech, P., Dencker, S. and Elgen, K. (1987). The UKU side effect rating scale. Acta Psychiatrica Scandinavica, 34, 1–100.Google Scholar
Maletic, V. and Raison, C. L. (2009). Neurobiology of depression, fibromyalgia and neuropathic pain. Frontiers in Bioscience (Landmark Ed), 14, 5291–5338.Google Scholar
Margolis, R. B., Tait, R. C. and Krause, S. J. (1986). A rating system for use with patient pain drawings. Pain, 24, 57–65.CrossRefGoogle ScholarPubMed
Mease, P. (2005). Fibromyalgia syndrome: review of clinical presentation, pathogenesis, outcome measures, and treatment. Journal of Rheumatology Supplement, 75, 6–21.Google Scholar
Mease, P. J. et al. (2008). Identifying the clinical domains of fibromyalgia: contributions from clinician and patient Delphi exercises. Arthritis Rheumatology, 59, 952–960.Google Scholar
Perrot, S., Bouhassira, D., Fermanian, J. and Cercle d’Etude de la Douleur en, R. (2010). Development and validation of the Fibromyalgia Rapid Screening Tool (FiRST). Pain, 150, 250–256.Google Scholar
Pope, H. G. Jr, and Hudson, J. I. (1991). A supplemental interview for forms of “affective spectrum disorder.” International Journal Psychiatry in Medicine, 21, 205–232.Google Scholar
Shega, J. W., Paice, J. A., Rockwood, K. and Dale, W. (2010). Is the presence of mild to moderate cognitive impairment associated with self-report of non-cancer pain? A cross-sectional analysis of a large population-based study. Journal of Pain and Symptom Management, 39, 734–742.Google Scholar
Spitzer, R. L. et al. (1994). Utility of a new procedure for diagnosing mental disorders in primary care. The PRIME-MD 1000 study. JAMA, 272, 1749–1756.Google Scholar
Teng, E. L. and Chui, H. C. (1987). The Modified Mini-Mental State (3MS) examination. Journal of Clinical Psychiatry, 48, 314–318.Google Scholar
Thieme, K., Turk, D. C. and Flor, H. (2004). Comorbid depression and anxiety in fibromyalgia syndrome: relationship to somatic and psychosocial variables. Psychosomatic Medicine, 66, 837–844.Google Scholar
Weiner, D. K. (2007). Office management of chronic pain in the elderly. The American Journal of Medicine, 120, 306–315.CrossRefGoogle ScholarPubMed
Weiner, D., Peterson, B. and Keefe, F. (1998). Evaluating persistent pain in long term care residents: what role for pain maps? Pain, 76, 249–257.Google Scholar
White, K. P., Nielson, W. R., Harth, M., Ostbye, T. and Speechley, M. (2002). Chronic widespread musculoskeletal pain with or without fibromyalgia: psychological distress in a representative community adult sample. Journal of Rheumatology, 29, 588–594.Google Scholar
Wolfe, F. and Hawley, D. J. (1998). Psychosocial factors and the fibromyalgia syndrome. Rheumatology, 57 (Suppl. 2), 88–91.Google Scholar
Wolfe, F., Ross, K., Anderson, J., Russell, I. J. and Hebert, L. (1995). The prevalence and characteristics of fibromyalgia in the general population. Arthritis Rheumatology, 38, 19–28.Google Scholar
Wolfe, F. et al. (1990). The American college of Rheumatology 1990 criteria for the classification of fibromyalgia. Report of the multicenter criteria committee. Arthritis Rheumatology, 33, 160–172.CrossRefGoogle ScholarPubMed
Wolfe, F. et al. (2010). The American College of Rheumatology preliminary diagnostic criteria for fibromyalgia and measurement of symptom severity. Arthritis Care Research (Hoboken), 62, 600–610.Google Scholar
Wolfe, F. et al. (2011). Fibromyalgia criteria and severity scales for clinical and epidemiological studies: a modification of the ACR preliminary diagnostic criteria for fibromyalgia. Journal of Rheumatology, 38, 1113–1122.Google Scholar